The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Robert Steele - One of the best experts on this subject based on the ideXlab platform.
-
HealthPass: Fine-Grained Access Control to Portable Personal Health Records
2010 24th IEEE International Conference on Advanced Information Networking and Applications, 2010Co-Authors: Robert SteeleAbstract:At present, emerging possibilities for patients to access their health records or health information may potentially lead to changes within the current health care delivery system from an institution-centered to a Patient-Centered Model and an electronic personal health record (PHR) may greatly influence such a shift. However, the use of PHRs does introduce specific challenges in terms of accidental disclosure of or malicious access to an individual's health data. Hence a high level of security for data access is required due to the sensitivity and confidentiality of the health data in PHRs. In this paper, we present extensible Models for defining and configuring fine-grained, role-based access control policies for XML-based portable personal health records using an extended digital certificate approach, called HealthPass which enables flexible and dynamic interactions without using a classical authorization and authentication approach like username and password.
-
AINA - HealthPass: Fine-Grained Access Control to Portable Personal Health Records
2010 24th IEEE International Conference on Advanced Information Networking and Applications, 2010Co-Authors: Robert SteeleAbstract:At present, emerging possibilities for patients to access their health records or health information may potentially lead to changes within the current health care delivery system from an institution-centered to a Patient-Centered Model and an electronic personal health record (PHR) may greatly influence such a shift. However, the use of PHRs does introduce specific challenges in terms of accidental disclosure of or malicious access to an individual’s health data. Hence a high level of security for data access is required due to the sensitivity and confidentiality of the health data in PHRs. In this paper, we present extensible Models for defining and configuring fine-grained, role-based access control policies for XML-based portable personal health records using an extended digital certificate approach, called HealthPass which enables flexible and dynamic interactions without using a classical authorization and authentication approach like username and password.
Victor M. Montori - One of the best experts on this subject based on the ideXlab platform.
-
Primary Prevention with Statins: Strategies to Support Shared Decision-Making
Current Cardiovascular Risk Reports, 2017Co-Authors: Erica S. Spatz, Victor M. MontoriAbstract:This paper proposes several strategies for health systems, primary care clinicians, cardiologists, and other members of the healthcare team to better engage individuals in decisions around primary preventive statin therapy. The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines for cholesterol management provide an opportunity to better engage patients in decisions about primary prevention of cardiovascular disease, including the initiation of statin therapy. In the shared decision making process, clinicians and patients work together to determine what is best for the patient, taking into account the scientific evidence informing guideline recommendations, the clinician’s knowledge and experience, the known burdens of taking a daily lifelong medication, and the patient’s preferences, values and goals. Several challenges exist to adopting shared decision making as a Patient-Centered Model of care.
-
Primary Prevention with Statins: Strategies to Support Shared Decision-Making
Current Cardiovascular Risk Reports, 2017Co-Authors: Erica S. Spatz, Victor M. MontoriAbstract:Purpose of Review This paper proposes several strategies for health systems, primary care clinicians, cardiologists, and other members of the healthcare team to better engage individuals in decisions around primary preventive statin therapy. Recent Findings The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines for cholesterol management provide an opportunity to better engage patients in decisions about primary prevention of cardiovascular disease, including the initiation of statin therapy. Summary In the shared decision making process, clinicians and patients work together to determine what is best for the patient, taking into account the scientific evidence informing guideline recommendations, the clinician’s knowledge and experience, the known burdens of taking a daily lifelong medication, and the patient’s preferences, values and goals. Several challenges exist to adopting shared decision making as a Patient-Centered Model of care.
-
Examining health promotion interventions for patients with chronic conditions using a novel Patient-Centered complexity Model: protocol for a systematic review and meta-analysis
Systematic Reviews, 2013Co-Authors: Amy E. Bodde, Nathan D. Shippee, Frances S. Mair, Patricia J. Erwin, M. Hassan Murad, Victor M. MontoriAbstract:Background Successful chronic care self-management requires adherence to healthy lifestyle behaviors, but many healthcare-based health promotion interventions have resulted in small and unsustainable changes in patient behavior. Patients with chronic conditions may already be overwhelmed by burdensome illnesses and treatments, and not have the capacity to respond well to the additional work required of behavior modifications. To explore this phenomenon, we will apply the cumulative complexity Model (CCM), a Patient-Centered Model of patient complexity, to a systematic review and meta-analysis of healthcare-based health behavior interventions.
-
Cumulative complexity: a functional, Patient-Centered Model of patient complexity can improve research and practice
Journal of Clinical Epidemiology, 2012Co-Authors: Nathan D. Shippee, Nilay D. Shah, Frances S. Mair, Victor M. MontoriAbstract:Abstract Objective To design a functional, Patient-Centered Model of patient complexity with practical applicability to analytic design and clinical practice. Existing literature on patient complexity has mainly identified its components descriptively and in isolation, lacking clarity as to their combined functions in disrupting care or to how complexity changes over time. Study Design and Setting The authors developed a cumulative complexity Model , which integrates existing literature and emphasizes how clinical and social factors accumulate and interact to complicate patient care. A narrative literature review is used to explicate the Model. Results The Model emphasizes a core, patient-level mechanism whereby complicating factors impact care and outcomes: the balance between patient workload of demands and patient capacity to address demands. Workload encompasses the demands on the patient's time and energy, including demands of treatment, self-care, and life in general. Capacity concerns ability to handle work (e.g., functional morbidity, financial/social resources, literacy). Workload-capacity imbalances comprise the mechanism driving patient complexity. Treatment and illness burdens serve as feedback loops, linking negative outcomes to further imbalances, such that complexity may accumulate over time. Conclusion With its components largely supported by existing literature, the Model has implications for analytic design, clinical epidemiology, and clinical practice.
Erica S. Spatz - One of the best experts on this subject based on the ideXlab platform.
-
Primary Prevention with Statins: Strategies to Support Shared Decision-Making
Current Cardiovascular Risk Reports, 2017Co-Authors: Erica S. Spatz, Victor M. MontoriAbstract:This paper proposes several strategies for health systems, primary care clinicians, cardiologists, and other members of the healthcare team to better engage individuals in decisions around primary preventive statin therapy. The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines for cholesterol management provide an opportunity to better engage patients in decisions about primary prevention of cardiovascular disease, including the initiation of statin therapy. In the shared decision making process, clinicians and patients work together to determine what is best for the patient, taking into account the scientific evidence informing guideline recommendations, the clinician’s knowledge and experience, the known burdens of taking a daily lifelong medication, and the patient’s preferences, values and goals. Several challenges exist to adopting shared decision making as a Patient-Centered Model of care.
-
Primary Prevention with Statins: Strategies to Support Shared Decision-Making
Current Cardiovascular Risk Reports, 2017Co-Authors: Erica S. Spatz, Victor M. MontoriAbstract:Purpose of Review This paper proposes several strategies for health systems, primary care clinicians, cardiologists, and other members of the healthcare team to better engage individuals in decisions around primary preventive statin therapy. Recent Findings The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines for cholesterol management provide an opportunity to better engage patients in decisions about primary prevention of cardiovascular disease, including the initiation of statin therapy. Summary In the shared decision making process, clinicians and patients work together to determine what is best for the patient, taking into account the scientific evidence informing guideline recommendations, the clinician’s knowledge and experience, the known burdens of taking a daily lifelong medication, and the patient’s preferences, values and goals. Several challenges exist to adopting shared decision making as a Patient-Centered Model of care.
Howard A. Heit - One of the best experts on this subject based on the ideXlab platform.
-
The Use of Drug Testing in Promoting Treatment Adherence in Pain Medicine
Oxford Medicine Online, 2020Co-Authors: Douglas L. Gourlay, Howard A. HeitAbstract:Drug testing has become an important component of a comprehensive risk assessment and mitigation program when prescribing controlled substances to patients with chronic pain. State and federal opioid prescribing guidelines strongly recommend the use of drug testing, although there is lack of evidence in the literature supporting the efficacy of drug testing in reducing prescription opioid abuse. Drug testing can be useful in facilitating adherence to prescribed medications. This chapter provides an overview of the strengths and weaknesses of drug testing in pain medicine, insights into laboratory and test selection, test interpretation, and communicating results to patients within a Patient-Centered Model.
-
Urine Drug Testing in Pain Medicine
Journal of Pain and Symptom Management, 2004Co-Authors: Howard A. Heit, Douglas L. GourlayAbstract:Abstract The use of urine drug testing (UDT) has increased over recent years. UDT results have traditionally been used in legal proceedings under supervision of a medical review officer (MRO). In this context, testing has been required by statute or regulation and so is typically not in the "donor's" interest. Physicians, however, can use UDT to assist in monitoring their patient's treatment plan. By using UDT in a Patient-Centered fashion, both patient and physician interests are maintained. The MRO-based Model of testing in the clinical setting can lead to mistrust and a deterioration of the doctor-patient relationship. Clinical testing can enhance the doctor-patient relationship when the results are used to improve communication. A Patient-Centered Model of UDT should be used to improve quality of care. This article discusses why urine is the biological specimen of choice for drug testing; who, when and why to test; testing methods; and, most importantly, interpretation of results.
Douglas L. Gourlay - One of the best experts on this subject based on the ideXlab platform.
-
The Use of Drug Testing in Promoting Treatment Adherence in Pain Medicine
Oxford Medicine Online, 2020Co-Authors: Douglas L. Gourlay, Howard A. HeitAbstract:Drug testing has become an important component of a comprehensive risk assessment and mitigation program when prescribing controlled substances to patients with chronic pain. State and federal opioid prescribing guidelines strongly recommend the use of drug testing, although there is lack of evidence in the literature supporting the efficacy of drug testing in reducing prescription opioid abuse. Drug testing can be useful in facilitating adherence to prescribed medications. This chapter provides an overview of the strengths and weaknesses of drug testing in pain medicine, insights into laboratory and test selection, test interpretation, and communicating results to patients within a Patient-Centered Model.
-
Urine Drug Testing in Pain Medicine
Journal of Pain and Symptom Management, 2004Co-Authors: Howard A. Heit, Douglas L. GourlayAbstract:Abstract The use of urine drug testing (UDT) has increased over recent years. UDT results have traditionally been used in legal proceedings under supervision of a medical review officer (MRO). In this context, testing has been required by statute or regulation and so is typically not in the "donor's" interest. Physicians, however, can use UDT to assist in monitoring their patient's treatment plan. By using UDT in a Patient-Centered fashion, both patient and physician interests are maintained. The MRO-based Model of testing in the clinical setting can lead to mistrust and a deterioration of the doctor-patient relationship. Clinical testing can enhance the doctor-patient relationship when the results are used to improve communication. A Patient-Centered Model of UDT should be used to improve quality of care. This article discusses why urine is the biological specimen of choice for drug testing; who, when and why to test; testing methods; and, most importantly, interpretation of results.